Illinois 2023-2024 Regular Session

Illinois Senate Bill SB1665 Compare Versions

Version 1 (Old)

Version 2 (New)

Old	New		Differences
1		-	Public Act 103-0492
2	1		SB1665 EnrolledLRB103 27577 KTG 53953 b SB1665 Enrolled LRB103 27577 KTG 53953 b
3	2		SB1665 Enrolled LRB103 27577 KTG 53953 b
4		-	AN ACT concerning public aid.
5		-	Be it enacted by the People of the State of Illinois,
6		-	represented in the General Assembly:
7		-	Section 5. The Hospital Uninsured Patient Discount Act is
8		-	amended by changing Sections 5, 10, and 15 as follows:
9		-	(210 ILCS 89/5)
10		-	Sec. 5. Definitions. As used in this Act:
11		-	"Community health center" means a federally qualified
12		-	health center as defined in Section 1905(l)(2)(B) of the
13		-	federal Social Security Act or a federally qualified health
14		-	center look-alike.
15		-	"Cost to charge ratio" means the ratio of a hospital's
16		-	costs to its charges taken from its most recently filed
17		-	Medicare cost report (CMS 2552-96 Worksheet C, Part I, PPS
18		-	Inpatient Ratios).
19		-	"Critical Access Hospital" means a hospital that is
20		-	designated as such under the federal Medicare Rural Hospital
21		-	Flexibility Program.
22		-	"Family income" means the sum of a family's annual
23		-	earnings and cash benefits from all sources before taxes, less
24		-	payments made for child support.
25		-	"Federal poverty income guidelines" means the poverty
26		-	guidelines updated periodically in the Federal Register by the
	3	+	1 AN ACT concerning public aid.
	4	+	2 Be it enacted by the People of the State of Illinois,
	5	+	3 represented in the General Assembly:
	6	+	4 Section 5. The Hospital Uninsured Patient Discount Act is
	7	+	5 amended by changing Sections 5, 10, and 15 as follows:
	8	+	6 (210 ILCS 89/5)
	9	+	7 Sec. 5. Definitions. As used in this Act:
	10	+	8 "Community health center" means a federally qualified
	11	+	9 health center as defined in Section 1905(l)(2)(B) of the
	12	+	10 federal Social Security Act or a federally qualified health
	13	+	11 center look-alike.
	14	+	12 "Cost to charge ratio" means the ratio of a hospital's
	15	+	13 costs to its charges taken from its most recently filed
	16	+	14 Medicare cost report (CMS 2552-96 Worksheet C, Part I, PPS
	17	+	15 Inpatient Ratios).
	18	+	16 "Critical Access Hospital" means a hospital that is
	19	+	17 designated as such under the federal Medicare Rural Hospital
	20	+	18 Flexibility Program.
	21	+	19 "Family income" means the sum of a family's annual
	22	+	20 earnings and cash benefits from all sources before taxes, less
	23	+	21 payments made for child support.
	24	+	22 "Federal poverty income guidelines" means the poverty
	25	+	23 guidelines updated periodically in the Federal Register by the
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33		-	United States Department of Health and Human Services under
34		-	authority of 42 U.S.C. 9902(2).
35		-	"Financial assistance" means a discount provided to a
36		-	patient under the terms and conditions a hospital offers to
37		-	qualified patients or as required by law.
38		-	"Free and charitable clinic" means a 501(c)(3) tax-exempt
39		-	health care organization providing health services to
40		-	low-income uninsured or underinsured individuals that is
41		-	recognized by either the Illinois Association of Free and
42		-	Charitable Clinics or the National Association of Free and
43		-	Charitable Clinics.
44		-	"Guaranteed income program" means a publicly or privately
45		-	funded program that provides one-time or recurring
46		-	unconditional cash transfers or payments, or gifts to
47		-	individuals or households, for a defined number of months or
48		-	years for the purposes of reducing poverty, promoting economic
49		-	mobility, or increasing the financial stability of Illinois
50		-	residents.
51		-	"Health care services" means any medically necessary
52		-	inpatient or outpatient hospital service, including
53		-	pharmaceuticals or supplies provided by a hospital to a
54		-	patient.
55		-	"Hospital" means any facility or institution required to
56		-	be licensed pursuant to the Hospital Licensing Act or operated
57		-	under the University of Illinois Hospital Act.
58		-	"Illinois resident" means any person who lives in Illinois
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	34	+	1 United States Department of Health and Human Services under
	35	+	2 authority of 42 U.S.C. 9902(2).
	36	+	3 "Financial assistance" means a discount provided to a
	37	+	4 patient under the terms and conditions a hospital offers to
	38	+	5 qualified patients or as required by law.
	39	+	6 "Free and charitable clinic" means a 501(c)(3) tax-exempt
	40	+	7 health care organization providing health services to
	41	+	8 low-income uninsured or underinsured individuals that is
	42	+	9 recognized by either the Illinois Association of Free and
	43	+	10 Charitable Clinics or the National Association of Free and
	44	+	11 Charitable Clinics.
	45	+	12 "Guaranteed income program" means a publicly or privately
	46	+	13 funded program that provides one-time or recurring
	47	+	14 unconditional cash transfers or payments, or gifts to
	48	+	15 individuals or households, for a defined number of months or
	49	+	16 years for the purposes of reducing poverty, promoting economic
	50	+	17 mobility, or increasing the financial stability of Illinois
	51	+	18 residents.
	52	+	19 "Health care services" means any medically necessary
	53	+	20 inpatient or outpatient hospital service, including
	54	+	21 pharmaceuticals or supplies provided by a hospital to a
	55	+	22 patient.
	56	+	23 "Hospital" means any facility or institution required to
	57	+	24 be licensed pursuant to the Hospital Licensing Act or operated
	58	+	25 under the University of Illinois Hospital Act.
	59	+	26 "Illinois resident" means any person who lives in Illinois
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61		-	and who intends to remain living in Illinois indefinitely.
62		-	Relocation to Illinois for the sole purpose of receiving
63		-	health care benefits does not satisfy the residency
64		-	requirement under this Act.
65		-	"Medically necessary" means any inpatient or outpatient
66		-	hospital service, including pharmaceuticals or supplies
67		-	provided by a hospital to a patient, covered under Title XVIII
68		-	of the federal Social Security Act for beneficiaries with the
69		-	same clinical presentation as the uninsured patient. A
70		-	"medically necessary" service does not include any of the
71		-	following:
72		-	(1) Non-medical services such as social and vocational
73		-	services.
74		-	(2) Elective cosmetic surgery, but not plastic surgery
75		-	designed to correct disfigurement caused by injury,
76		-	illness, or congenital defect or deformity.
77		-	"Rural hospital" means a hospital that is located outside
78		-	a metropolitan statistical area.
79		-	"Uninsured discount" means a hospital's charges multiplied
80		-	by the uninsured discount factor.
81		-	"Uninsured discount factor" means 1.0 less the product of
82		-	a hospital's cost to charge ratio multiplied by 1.35.
83		-	"Uninsured patient" means an Illinois resident who is a
84		-	patient of a hospital and is not covered under a policy of
85		-	health insurance and is not a beneficiary under a public or
86		-	private health insurance, health benefit, or other health
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88	63
89		-	coverage program, including high deductible health insurance
90		-	plans, workers' compensation, accident liability insurance, or
91		-	other third party liability.
92		-	(Source: P.A. 102-581, eff. 1-1-22.)
93		-	(210 ILCS 89/10)
94		-	Sec. 10. Uninsured patient discounts.
95		-	(a) Eligibility.
96		-	(1) A hospital, other than a rural hospital or
97		-	Critical Access Hospital, shall provide a discount from
98		-	its charges to any uninsured patient who applies for a
99		-	discount and has family income of not more than 600% of the
100		-	federal poverty income guidelines for all medically
101		-	necessary health care services exceeding $150 in any one
102		-	inpatient admission or outpatient encounter.
103		-	(2) A hospital, other than a rural hospital or
104		-	Critical Access Hospital, shall provide a charitable
105		-	discount of 100% of its charges for all medically
106		-	necessary health care services exceeding $150 in any one
107		-	inpatient admission or outpatient encounter to any
108		-	uninsured patient who applies for a discount and has
109		-	family income of not more than 200% of the federal poverty
110		-	income guidelines.
111		-	(3) A rural hospital or Critical Access Hospital shall
112		-	provide a discount from its charges to any uninsured
113		-	patient who applies for a discount and has annual family
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116		-	income of not more than 300% of the federal poverty income
117		-	guidelines for all medically necessary health care
118		-	services exceeding $300 in any one inpatient admission or
119		-	outpatient encounter.
120		-	(4) A rural hospital or Critical Access Hospital shall
121		-	provide a charitable discount of 100% of its charges for
122		-	all medically necessary health care services exceeding
123		-	$300 in any one inpatient admission or outpatient
124		-	encounter to any uninsured patient who applies for a
125		-	discount and has family income of not more than 125% of the
126		-	federal poverty income guidelines.
127		-	(5) In determining eligibility under this Act, a
128		-	hospital subject to this Act shall exclude from
129		-	consideration any unconditional cash transfers, payments,
130		-	or gifts received under a guaranteed income program if:
131		-	(A) such cash transfers, payments, or gifts are
132		-	excluded from consideration for determining
133		-	eligibility under public health insurance programs
134		-	administered by the State in which the State has the
135		-	authority to waive guaranteed income; and
136		-	(B) the guaranteed income program is a program for
137		-	a defined number of months or years designed to reduce
138		-	poverty, promote social mobility, or increase
139		-	financial stability for program participants and if
140		-	there is an explicit plan to collect data.
141		-	This paragraph is inoperative on and after July 1,
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	70	+	1 and who intends to remain living in Illinois indefinitely.
	71	+	2 Relocation to Illinois for the sole purpose of receiving
	72	+	3 health care benefits does not satisfy the residency
	73	+	4 requirement under this Act.
	74	+	5 "Medically necessary" means any inpatient or outpatient
	75	+	6 hospital service, including pharmaceuticals or supplies
	76	+	7 provided by a hospital to a patient, covered under Title XVIII
	77	+	8 of the federal Social Security Act for beneficiaries with the
	78	+	9 same clinical presentation as the uninsured patient. A
	79	+	10 "medically necessary" service does not include any of the
	80	+	11 following:
	81	+	12 (1) Non-medical services such as social and vocational
	82	+	13 services.
	83	+	14 (2) Elective cosmetic surgery, but not plastic surgery
	84	+	15 designed to correct disfigurement caused by injury,
	85	+	16 illness, or congenital defect or deformity.
	86	+	17 "Rural hospital" means a hospital that is located outside
	87	+	18 a metropolitan statistical area.
	88	+	19 "Uninsured discount" means a hospital's charges multiplied
	89	+	20 by the uninsured discount factor.
	90	+	21 "Uninsured discount factor" means 1.0 less the product of
	91	+	22 a hospital's cost to charge ratio multiplied by 1.35.
	92	+	23 "Uninsured patient" means an Illinois resident who is a
	93	+	24 patient of a hospital and is not covered under a policy of
	94	+	25 health insurance and is not a beneficiary under a public or
	95	+	26 private health insurance, health benefit, or other health
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144		-	2026.
145		-	(b) Discount. For all health care services exceeding $300
146		-	in any one inpatient admission or outpatient encounter, a
147		-	hospital shall not collect from an uninsured patient, deemed
148		-	eligible under subsection (a), more than its charges less the
149		-	amount of the uninsured discount.
150		-	(c) Maximum Collectible Amount.
151		-	(1) The maximum amount that may be collected in a
152		-	12-month period for health care services provided by the
153		-	hospital from a patient determined by that hospital to be
154		-	eligible under subsection (a) is 20% of the patient's
155		-	family income, and is subject to the patient's continued
156		-	eligibility under this Act.
157		-	(2) The 12-month period to which the maximum amount
158		-	applies shall begin on the first date, after the effective
159		-	date of this Act, an uninsured patient receives health
160		-	care services that are determined to be eligible for the
161		-	uninsured discount at that hospital.
162		-	(3) To be eligible to have this maximum amount applied
163		-	to subsequent charges, the uninsured patient shall inform
164		-	the hospital in subsequent inpatient admissions or
165		-	outpatient encounters that the patient has previously
166		-	received health care services from that hospital and was
167		-	determined to be entitled to the uninsured discount. The
168		-	availability of the maximum collectible amount shall be
169		-	included in the hospital's financial assistance
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172		-	information provided to uninsured patients.
173		-	(4) Hospitals may adopt policies to exclude an
174		-	uninsured patient from the application of subdivision
175		-	(c)(1) when the patient owns assets having a value in
176		-	excess of 600% of the federal poverty level for hospitals
177		-	in a metropolitan statistical area or owns assets having a
178		-	value in excess of 300% of the federal poverty level for
179		-	Critical Access Hospitals or hospitals outside a
180		-	metropolitan statistical area, not counting the following
181		-	assets: the uninsured patient's primary residence;
182		-	personal property exempt from judgment under Section
183		-	12-1001 of the Code of Civil Procedure; or any amounts
184		-	held in a pension or retirement plan, provided, however,
185		-	that distributions and payments from pension or retirement
186		-	plans may be included as income for the purposes of this
187		-	Act.
188		-	(d) Each hospital bill, invoice, or other summary of
189		-	charges to an uninsured patient shall include with it, or on
190		-	it, a prominent statement that an uninsured patient who meets
191		-	certain income requirements may qualify for an uninsured
192		-	discount and information regarding how an uninsured patient
193		-	may apply for consideration under the hospital's financial
194		-	assistance policy. The hospital's financial assistance
195		-	application shall include language that directs the uninsured
196		-	patient to contact the hospital's financial counseling
197		-	department with questions or concerns, along with contact
	100	+
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200		-	information for the financial counseling department, and shall
201		-	state: "Complaints or concerns with the uninsured patient
202		-	discount application process or hospital financial assistance
203		-	process may be reported to the Health Care Bureau of the
204		-	Illinois Attorney General.". A website, phone number, or both
205		-	provided by the Attorney General shall be included with this
206		-	statement.
207		-	(Source: P.A. 102-581, eff. 1-1-22.)
208		-	(210 ILCS 89/15)
209		-	Sec. 15. Patient responsibility.
210		-	(a) Hospitals may make the availability of a discount and
211		-	the maximum collectible amount under this Act contingent upon
212		-	the uninsured patient first applying for coverage under public
213		-	health insurance programs, such as Medicare, Medicaid,
214		-	AllKids, the State Children's Health Insurance Program, the
215		-	Health Benefits for Immigrants program, or any other program,
216		-	if there is a reasonable basis to believe that the uninsured
217		-	patient may be eligible for such program.
218		-	(b) Hospitals shall permit an uninsured patient to apply
219		-	for a discount within 90 days of the date of discharge or date
220		-	of service.
221		-	Hospitals shall offer uninsured patients who receive
222		-	community-based primary care provided by a community health
223		-	center or a free and charitable clinic, are referred by such an
224		-	entity to the hospital, and seek access to nonemergency
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	105	+	SB1665 Enrolled - 4 - LRB103 27577 KTG 53953 b
	106	+	1 coverage program, including high deductible health insurance
	107	+	2 plans, workers' compensation, accident liability insurance, or
	108	+	3 other third party liability.
	109	+	4 (Source: P.A. 102-581, eff. 1-1-22.)
	110	+	5 (210 ILCS 89/10)
	111	+	6 Sec. 10. Uninsured patient discounts.
	112	+	7 (a) Eligibility.
	113	+	8 (1) A hospital, other than a rural hospital or
	114	+	9 Critical Access Hospital, shall provide a discount from
	115	+	10 its charges to any uninsured patient who applies for a
	116	+	11 discount and has family income of not more than 600% of the
	117	+	12 federal poverty income guidelines for all medically
	118	+	13 necessary health care services exceeding $150 in any one
	119	+	14 inpatient admission or outpatient encounter.
	120	+	15 (2) A hospital, other than a rural hospital or
	121	+	16 Critical Access Hospital, shall provide a charitable
	122	+	17 discount of 100% of its charges for all medically
	123	+	18 necessary health care services exceeding $150 in any one
	124	+	19 inpatient admission or outpatient encounter to any
	125	+	20 uninsured patient who applies for a discount and has
	126	+	21 family income of not more than 200% of the federal poverty
	127	+	22 income guidelines.
	128	+	23 (3) A rural hospital or Critical Access Hospital shall
	129	+	24 provide a discount from its charges to any uninsured
	130	+	25 patient who applies for a discount and has annual family
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226	132
227		-	hospital-based health care services with an opportunity to be
228		-	screened for and assistance with applying for public health
229		-	insurance programs if there is a reasonable basis to believe
230		-	that the uninsured patient may be eligible for a public health
231		-	insurance program. An uninsured patient who receives
232		-	community-based primary care provided by a community health
233		-	center or free and charitable clinic and is referred by such an
234		-	entity to the hospital for whom there is not a reasonable basis
235		-	to believe that the uninsured patient may be eligible for a
236		-	public health insurance program shall be given the opportunity
237		-	to apply for hospital financial assistance when hospital
238		-	services are scheduled.
239		-	(1) Income verification. Hospitals may require an
240		-	uninsured patient who is requesting an uninsured discount
241		-	to provide documentation of family income. Acceptable
242		-	family income documentation shall include any one of the
243		-	following:
244		-	(A) a copy of the most recent tax return;
245		-	(B) a copy of the most recent W-2 form and 1099
246		-	forms;
247		-	(C) copies of the 2 most recent pay stubs;
248		-	(D) written income verification from an employer
249		-	if paid in cash; or
250		-	(E) one other reasonable form of third party
251		-	income verification deemed acceptable to the hospital.
252		-	(2) Asset verification. Hospitals may require an
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254	134
255		-	uninsured patient who is requesting an uninsured discount
256		-	to certify the existence or absence of assets owned by the
257		-	patient and to provide documentation of the value of such
258		-	assets, except for those assets referenced in paragraph
259		-	(4) of subsection (c) of Section 10. Acceptable
260		-	documentation may include statements from financial
261		-	institutions or some other third party verification of an
262		-	asset's value. If no third party verification exists, then
263		-	the patient shall certify as to the estimated value of the
264		-	asset.
265		-	(3) Illinois resident verification. Hospitals may
266		-	require an uninsured patient who is requesting an
267		-	uninsured discount to verify Illinois residency.
268		-	Acceptable verification of Illinois residency shall
269		-	include any one of the following:
270		-	(A) any of the documents listed in paragraph (1);
271		-	(B) a valid state-issued identification card;
272		-	(C) a recent residential utility bill;
273		-	(D) a lease agreement;
274		-	(E) a vehicle registration card;
275		-	(F) a voter registration card;
276		-	(G) mail addressed to the uninsured patient at an
277		-	Illinois address from a government or other credible
278		-	source;
279		-	(H) a statement from a family member of the
280		-	uninsured patient who resides at the same address and
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283		-	presents verification of residency;
284		-	(I) a letter from a homeless shelter, transitional
285		-	house or other similar facility verifying that the
286		-	uninsured patient resides at the facility; or
287		-	(J) a temporary visitor's drivers license.
288		-	(c) Hospital obligations toward an individual uninsured
289		-	patient under this Act shall cease if that patient
290		-	unreasonably fails or refuses to provide the hospital with
291		-	information or documentation requested under subsection (b) or
292		-	to apply for coverage under public programs when requested
293		-	under subsection (a) within 30 days of the hospital's request.
294		-	(d) In order for a hospital to determine the 12 month
295		-	maximum amount that can be collected from a patient deemed
296		-	eligible under Section 10, an uninsured patient shall inform
297		-	the hospital in subsequent inpatient admissions or outpatient
298		-	encounters that the patient has previously received health
299		-	care services from that hospital and was determined to be
300		-	entitled to the uninsured discount.
301		-	(e) Hospitals may require patients to certify that all of
302		-	the information provided in the application is true. The
303		-	application may state that if any of the information is
304		-	untrue, any discount granted to the patient is forfeited and
305		-	the patient is responsible for payment of the hospital's full
306		-	charges.
307		-	(f) Hospitals shall ask for an applicant's race,
308		-	ethnicity, sex, and preferred language on the financial
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	141	+	1 income of not more than 300% of the federal poverty income
	142	+	2 guidelines for all medically necessary health care
	143	+	3 services exceeding $300 in any one inpatient admission or
	144	+	4 outpatient encounter.
	145	+	5 (4) A rural hospital or Critical Access Hospital shall
	146	+	6 provide a charitable discount of 100% of its charges for
	147	+	7 all medically necessary health care services exceeding
	148	+	8 $300 in any one inpatient admission or outpatient
	149	+	9 encounter to any uninsured patient who applies for a
	150	+	10 discount and has family income of not more than 125% of the
	151	+	11 federal poverty income guidelines.
	152	+	12 (5) In determining eligibility under this Act, a
	153	+	13 hospital subject to this Act shall exclude from
	154	+	14 consideration any unconditional cash transfers, payments,
	155	+	15 or gifts received under a guaranteed income program if:
	156	+	16 (A) such cash transfers, payments, or gifts are
	157	+	17 excluded from consideration for determining
	158	+	18 eligibility under public health insurance programs
	159	+	19 administered by the State in which the State has the
	160	+	20 authority to waive guaranteed income; and
	161	+	21 (B) the guaranteed income program is a program for
	162	+	22 a defined number of months or years designed to reduce
	163	+	23 poverty, promote social mobility, or increase
	164	+	24 financial stability for program participants and if
	165	+	25 there is an explicit plan to collect data.
	166	+	26 This paragraph is inoperative on and after July 1,
309	167
310	168
311		-	assistance application. However, the questions shall be
312		-	clearly marked as optional responses for the patient and shall
313		-	note that responses or nonresponses by the patient will not
314		-	have any impact on the outcome of the application.
315		-	(Source: P.A. 102-581, eff. 1-1-22.)
316		-	Section 10. The Illinois Public Aid Code is amended by
317		-	changing Section 1-7 as follows:
318		-	(305 ILCS 5/1-7) (from Ch. 23, par. 1-7)
319		-	Sec. 1-7. (a) For purposes of determining eligibility for
320		-	assistance under this Code, the Illinois Department, County
321		-	Departments, and local governmental units shall exclude from
322		-	consideration restitution payments, including all income and
323		-	resources derived therefrom, made to persons of Japanese or
324		-	Aleutian ancestry pursuant to the federal Civil Liberties Act
325		-	of 1988 and the Aleutian and Pribilof Island Restitution Act,
326		-	P.L. 100-383.
327		-	(b) For purposes of any program or form of assistance
328		-	where a person's income or assets are considered in
329		-	determining eligibility or level of assistance, whether under
330		-	this Code or another authority, neither the State of Illinois
331		-	nor any entity or person administering a program wholly or
332		-	partially financed by the State of Illinois or any of its
333		-	political subdivisions shall include restitution payments,
334		-	including all income and resources derived therefrom, made
335	169
336	170
337		-	pursuant to the federal Civil Liberties Act of 1988 and the
338		-	Aleutian and Pribilof Island Restitution Act, P.L. 100-383, in
339		-	the calculation of income or assets for determining
340		-	eligibility or level of assistance.
341		-	(c) For purposes of determining eligibility for or the
342		-	amount of assistance under this Code, except for the
343		-	determination of eligibility for payments or programs under
344		-	the TANF employment, education, and training programs and the
345		-	Food Stamp Employment and Training Program, the Illinois
346		-	Department, County Departments, and local governmental units
347		-	shall exclude from consideration any financial assistance
348		-	received under any student aid program administered by an
349		-	agency of this State or the federal government, by a person who
350		-	is enrolled as a full-time or part-time student of any public
351		-	or private university, college, or community college in this
352		-	State.
353		-	(d) For purposes of determining eligibility for or the
354		-	amount of assistance under this Code, except for the
355		-	determination of eligibility for payments or programs under
356		-	the TANF employment, education, and training programs and the
357		-	SNAP Employment and Training Program, the Illinois Department,
358		-	County Departments, and local governmental units shall exclude
359		-	from consideration, for a period of 36 months, any financial
360		-	assistance, including wages, that is provided to a person who
361		-	is enrolled in a demonstration project that is not funded with
362		-	general revenue funds and that is intended as a bridge to
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363	173
364	174
365		-	self-sufficiency by offering (i) intensive workforce support
366		-	and training and (ii) support services for new and expectant
367		-	parents that are intended to foster multi-generational healthy
368		-	families as described in Section 12-4.51.
369		-	(e)(1) Notwithstanding any other provision of this Code,
370		-	and to the maximum extent permitted by federal law, for
371		-	purposes of determining eligibility and the amount of
372		-	assistance under this Code, the Illinois Department and local
373		-	governmental units shall exclude from consideration, for a
374		-	period of no more than 60 months, any financial assistance,
375		-	including wages, cash transfers, or gifts, that is provided to
376		-	a person through a guaranteed income program. As used in this
377		-	subsection, "guaranteed income program" means a publicly or
378		-	privately funded program that provides one-time or recurring
379		-	unconditional cash transfers or payments, or gifts to
380		-	individuals or households, for a defined number of months or
381		-	years for the purposes of reducing poverty, promoting economic
382		-	mobility, or increasing the financial stability of Illinois
383		-	residents. who is enrolled in a program or research project
384		-	that is not funded with general revenue funds and that is
385		-	intended to investigate the impacts of policies or programs
386		-	designed to reduce poverty, promote social mobility, or
387		-	increase financial stability for Illinois residents if there
388		-	is an explicit plan to collect data and evaluate the program or
389		-	initiative that is developed prior to participants in the
390		-	study being enrolled in the program and if a research team has
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	177	+	1 2026.
	178	+	2 (b) Discount. For all health care services exceeding $300
	179	+	3 in any one inpatient admission or outpatient encounter, a
	180	+	4 hospital shall not collect from an uninsured patient, deemed
	181	+	5 eligible under subsection (a), more than its charges less the
	182	+	6 amount of the uninsured discount.
	183	+	7 (c) Maximum Collectible Amount.
	184	+	8 (1) The maximum amount that may be collected in a
	185	+	9 12-month period for health care services provided by the
	186	+	10 hospital from a patient determined by that hospital to be
	187	+	11 eligible under subsection (a) is 20% of the patient's
	188	+	12 family income, and is subject to the patient's continued
	189	+	13 eligibility under this Act.
	190	+	14 (2) The 12-month period to which the maximum amount
	191	+	15 applies shall begin on the first date, after the effective
	192	+	16 date of this Act, an uninsured patient receives health
	193	+	17 care services that are determined to be eligible for the
	194	+	18 uninsured discount at that hospital.
	195	+	19 (3) To be eligible to have this maximum amount applied
	196	+	20 to subsequent charges, the uninsured patient shall inform
	197	+	21 the hospital in subsequent inpatient admissions or
	198	+	22 outpatient encounters that the patient has previously
	199	+	23 received health care services from that hospital and was
	200	+	24 determined to be entitled to the uninsured discount. The
	201	+	25 availability of the maximum collectible amount shall be
	202	+	26 included in the hospital's financial assistance
391	203
392	204
393		-	been identified to oversee the evaluation.
394		-	(2) The Department shall choose State options and seek all
395		-	necessary federal approvals or waivers to implement this
396		-	subsection.
397		-	(Source: P.A. 100-806, eff. 1-1-19; 101-415, eff. 8-16-19.)
398		-	Section 99. Effective date. This Act takes effect January
399		-	1, 2024.
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	209	+
	210	+
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	213	+	1 information provided to uninsured patients.
	214	+	2 (4) Hospitals may adopt policies to exclude an
	215	+	3 uninsured patient from the application of subdivision
	216	+	4 (c)(1) when the patient owns assets having a value in
	217	+	5 excess of 600% of the federal poverty level for hospitals
	218	+	6 in a metropolitan statistical area or owns assets having a
	219	+	7 value in excess of 300% of the federal poverty level for
	220	+	8 Critical Access Hospitals or hospitals outside a
	221	+	9 metropolitan statistical area, not counting the following
	222	+	10 assets: the uninsured patient's primary residence;
	223	+	11 personal property exempt from judgment under Section
	224	+	12 12-1001 of the Code of Civil Procedure; or any amounts
	225	+	13 held in a pension or retirement plan, provided, however,
	226	+	14 that distributions and payments from pension or retirement
	227	+	15 plans may be included as income for the purposes of this
	228	+	16 Act.
	229	+	17 (d) Each hospital bill, invoice, or other summary of
	230	+	18 charges to an uninsured patient shall include with it, or on
	231	+	19 it, a prominent statement that an uninsured patient who meets
	232	+	20 certain income requirements may qualify for an uninsured
	233	+	21 discount and information regarding how an uninsured patient
	234	+	22 may apply for consideration under the hospital's financial
	235	+	23 assistance policy. The hospital's financial assistance
	236	+	24 application shall include language that directs the uninsured
	237	+	25 patient to contact the hospital's financial counseling
	238	+	26 department with questions or concerns, along with contact
	239	+
	240	+
	241	+
	242	+
	243	+
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	245	+
	246	+
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	248	+	SB1665 Enrolled - 8 - LRB103 27577 KTG 53953 b
	249	+	1 information for the financial counseling department, and shall
	250	+	2 state: "Complaints or concerns with the uninsured patient
	251	+	3 discount application process or hospital financial assistance
	252	+	4 process may be reported to the Health Care Bureau of the
	253	+	5 Illinois Attorney General.". A website, phone number, or both
	254	+	6 provided by the Attorney General shall be included with this
	255	+	7 statement.
	256	+	8 (Source: P.A. 102-581, eff. 1-1-22.)
	257	+	9 (210 ILCS 89/15)
	258	+	10 Sec. 15. Patient responsibility.
	259	+	11 (a) Hospitals may make the availability of a discount and
	260	+	12 the maximum collectible amount under this Act contingent upon
	261	+	13 the uninsured patient first applying for coverage under public
	262	+	14 health insurance programs, such as Medicare, Medicaid,
	263	+	15 AllKids, the State Children's Health Insurance Program, the
	264	+	16 Health Benefits for Immigrants program, or any other program,
	265	+	17 if there is a reasonable basis to believe that the uninsured
	266	+	18 patient may be eligible for such program.
	267	+	19 (b) Hospitals shall permit an uninsured patient to apply
	268	+	20 for a discount within 90 days of the date of discharge or date
	269	+	21 of service.
	270	+	22 Hospitals shall offer uninsured patients who receive
	271	+	23 community-based primary care provided by a community health
	272	+	24 center or a free and charitable clinic, are referred by such an
	273	+	25 entity to the hospital, and seek access to nonemergency
	274	+
	275	+
	276	+
	277	+
	278	+
	279	+	SB1665 Enrolled - 8 - LRB103 27577 KTG 53953 b
	280	+
	281	+
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	283	+	SB1665 Enrolled - 9 - LRB103 27577 KTG 53953 b
	284	+	1 hospital-based health care services with an opportunity to be
	285	+	2 screened for and assistance with applying for public health
	286	+	3 insurance programs if there is a reasonable basis to believe
	287	+	4 that the uninsured patient may be eligible for a public health
	288	+	5 insurance program. An uninsured patient who receives
	289	+	6 community-based primary care provided by a community health
	290	+	7 center or free and charitable clinic and is referred by such an
	291	+	8 entity to the hospital for whom there is not a reasonable basis
	292	+	9 to believe that the uninsured patient may be eligible for a
	293	+	10 public health insurance program shall be given the opportunity
	294	+	11 to apply for hospital financial assistance when hospital
	295	+	12 services are scheduled.
	296	+	13 (1) Income verification. Hospitals may require an
	297	+	14 uninsured patient who is requesting an uninsured discount
	298	+	15 to provide documentation of family income. Acceptable
	299	+	16 family income documentation shall include any one of the
	300	+	17 following:
	301	+	18 (A) a copy of the most recent tax return;
	302	+	19 (B) a copy of the most recent W-2 form and 1099
	303	+	20 forms;
	304	+	21 (C) copies of the 2 most recent pay stubs;
	305	+	22 (D) written income verification from an employer
	306	+	23 if paid in cash; or
	307	+	24 (E) one other reasonable form of third party
	308	+	25 income verification deemed acceptable to the hospital.
	309	+	26 (2) Asset verification. Hospitals may require an
	310	+
	311	+
	312	+
	313	+
	314	+
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	316	+
	317	+
	318	+	SB1665 Enrolled- 10 -LRB103 27577 KTG 53953 b SB1665 Enrolled - 10 - LRB103 27577 KTG 53953 b
	319	+	SB1665 Enrolled - 10 - LRB103 27577 KTG 53953 b
	320	+	1 uninsured patient who is requesting an uninsured discount
	321	+	2 to certify the existence or absence of assets owned by the
	322	+	3 patient and to provide documentation of the value of such
	323	+	4 assets, except for those assets referenced in paragraph
	324	+	5 (4) of subsection (c) of Section 10. Acceptable
	325	+	6 documentation may include statements from financial
	326	+	7 institutions or some other third party verification of an
	327	+	8 asset's value. If no third party verification exists, then
	328	+	9 the patient shall certify as to the estimated value of the
	329	+	10 asset.
	330	+	11 (3) Illinois resident verification. Hospitals may
	331	+	12 require an uninsured patient who is requesting an
	332	+	13 uninsured discount to verify Illinois residency.
	333	+	14 Acceptable verification of Illinois residency shall
	334	+	15 include any one of the following:
	335	+	16 (A) any of the documents listed in paragraph (1);
	336	+	17 (B) a valid state-issued identification card;
	337	+	18 (C) a recent residential utility bill;
	338	+	19 (D) a lease agreement;
	339	+	20 (E) a vehicle registration card;
	340	+	21 (F) a voter registration card;
	341	+	22 (G) mail addressed to the uninsured patient at an
	342	+	23 Illinois address from a government or other credible
	343	+	24 source;
	344	+	25 (H) a statement from a family member of the
	345	+	26 uninsured patient who resides at the same address and
	346	+
	347	+
	348	+
	349	+
	350	+
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	352	+
	353	+
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	355	+	SB1665 Enrolled - 11 - LRB103 27577 KTG 53953 b
	356	+	1 presents verification of residency;
	357	+	2 (I) a letter from a homeless shelter, transitional
	358	+	3 house or other similar facility verifying that the
	359	+	4 uninsured patient resides at the facility; or
	360	+	5 (J) a temporary visitor's drivers license.
	361	+	6 (c) Hospital obligations toward an individual uninsured
	362	+	7 patient under this Act shall cease if that patient
	363	+	8 unreasonably fails or refuses to provide the hospital with
	364	+	9 information or documentation requested under subsection (b) or
	365	+	10 to apply for coverage under public programs when requested
	366	+	11 under subsection (a) within 30 days of the hospital's request.
	367	+	12 (d) In order for a hospital to determine the 12 month
	368	+	13 maximum amount that can be collected from a patient deemed
	369	+	14 eligible under Section 10, an uninsured patient shall inform
	370	+	15 the hospital in subsequent inpatient admissions or outpatient
	371	+	16 encounters that the patient has previously received health
	372	+	17 care services from that hospital and was determined to be
	373	+	18 entitled to the uninsured discount.
	374	+	19 (e) Hospitals may require patients to certify that all of
	375	+	20 the information provided in the application is true. The
	376	+	21 application may state that if any of the information is
	377	+	22 untrue, any discount granted to the patient is forfeited and
	378	+	23 the patient is responsible for payment of the hospital's full
	379	+	24 charges.
	380	+	25 (f) Hospitals shall ask for an applicant's race,
	381	+	26 ethnicity, sex, and preferred language on the financial
	382	+
	383	+
	384	+
	385	+
	386	+
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	388	+
	389	+
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	392	+	1 assistance application. However, the questions shall be
	393	+	2 clearly marked as optional responses for the patient and shall
	394	+	3 note that responses or nonresponses by the patient will not
	395	+	4 have any impact on the outcome of the application.
	396	+	5 (Source: P.A. 102-581, eff. 1-1-22.)
	397	+	6 Section 10. The Illinois Public Aid Code is amended by
	398	+	7 changing Section 1-7 as follows:
	399	+	8 (305 ILCS 5/1-7) (from Ch. 23, par. 1-7)
	400	+	9 Sec. 1-7. (a) For purposes of determining eligibility for
	401	+	10 assistance under this Code, the Illinois Department, County
	402	+	11 Departments, and local governmental units shall exclude from
	403	+	12 consideration restitution payments, including all income and
	404	+	13 resources derived therefrom, made to persons of Japanese or
	405	+	14 Aleutian ancestry pursuant to the federal Civil Liberties Act
	406	+	15 of 1988 and the Aleutian and Pribilof Island Restitution Act,
	407	+	16 P.L. 100-383.
	408	+	17 (b) For purposes of any program or form of assistance
	409	+	18 where a person's income or assets are considered in
	410	+	19 determining eligibility or level of assistance, whether under
	411	+	20 this Code or another authority, neither the State of Illinois
	412	+	21 nor any entity or person administering a program wholly or
	413	+	22 partially financed by the State of Illinois or any of its
	414	+	23 political subdivisions shall include restitution payments,
	415	+	24 including all income and resources derived therefrom, made
	416	+
	417	+
	418	+
	419	+
	420	+
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	422	+
	423	+
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	426	+	1 pursuant to the federal Civil Liberties Act of 1988 and the
	427	+	2 Aleutian and Pribilof Island Restitution Act, P.L. 100-383, in
	428	+	3 the calculation of income or assets for determining
	429	+	4 eligibility or level of assistance.
	430	+	5 (c) For purposes of determining eligibility for or the
	431	+	6 amount of assistance under this Code, except for the
	432	+	7 determination of eligibility for payments or programs under
	433	+	8 the TANF employment, education, and training programs and the
	434	+	9 Food Stamp Employment and Training Program, the Illinois
	435	+	10 Department, County Departments, and local governmental units
	436	+	11 shall exclude from consideration any financial assistance
	437	+	12 received under any student aid program administered by an
	438	+	13 agency of this State or the federal government, by a person who
	439	+	14 is enrolled as a full-time or part-time student of any public
	440	+	15 or private university, college, or community college in this
	441	+	16 State.
	442	+	17 (d) For purposes of determining eligibility for or the
	443	+	18 amount of assistance under this Code, except for the
	444	+	19 determination of eligibility for payments or programs under
	445	+	20 the TANF employment, education, and training programs and the
	446	+	21 SNAP Employment and Training Program, the Illinois Department,
	447	+	22 County Departments, and local governmental units shall exclude
	448	+	23 from consideration, for a period of 36 months, any financial
	449	+	24 assistance, including wages, that is provided to a person who
	450	+	25 is enrolled in a demonstration project that is not funded with
	451	+	26 general revenue funds and that is intended as a bridge to
	452	+
	453	+
	454	+
	455	+
	456	+
	457	+	SB1665 Enrolled - 13 - LRB103 27577 KTG 53953 b
	458	+
	459	+
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	461	+	SB1665 Enrolled - 14 - LRB103 27577 KTG 53953 b
	462	+	1 self-sufficiency by offering (i) intensive workforce support
	463	+	2 and training and (ii) support services for new and expectant
	464	+	3 parents that are intended to foster multi-generational healthy
	465	+	4 families as described in Section 12-4.51.
	466	+	5 (e)(1) Notwithstanding any other provision of this Code,
	467	+	6 and to the maximum extent permitted by federal law, for
	468	+	7 purposes of determining eligibility and the amount of
	469	+	8 assistance under this Code, the Illinois Department and local
	470	+	9 governmental units shall exclude from consideration, for a
	471	+	10 period of no more than 60 months, any financial assistance,
	472	+	11 including wages, cash transfers, or gifts, that is provided to
	473	+	12 a person through a guaranteed income program. As used in this
	474	+	13 subsection, "guaranteed income program" means a publicly or
	475	+	14 privately funded program that provides one-time or recurring
	476	+	15 unconditional cash transfers or payments, or gifts to
	477	+	16 individuals or households, for a defined number of months or
	478	+	17 years for the purposes of reducing poverty, promoting economic
	479	+	18 mobility, or increasing the financial stability of Illinois
	480	+	19 residents. who is enrolled in a program or research project
	481	+	20 that is not funded with general revenue funds and that is
	482	+	21 intended to investigate the impacts of policies or programs
	483	+	22 designed to reduce poverty, promote social mobility, or
	484	+	23 increase financial stability for Illinois residents if there
	485	+	24 is an explicit plan to collect data and evaluate the program or
	486	+	25 initiative that is developed prior to participants in the
	487	+	26 study being enrolled in the program and if a research team has
	488	+
	489	+
	490	+
	491	+
	492	+
	493	+	SB1665 Enrolled - 14 - LRB103 27577 KTG 53953 b
	494	+
	495	+
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	498	+	1 been identified to oversee the evaluation.
	499	+	2 (2) The Department shall choose State options and seek all
	500	+	3 necessary federal approvals or waivers to implement this
	501	+	4 subsection.
	502	+	5 (Source: P.A. 100-806, eff. 1-1-19; 101-415, eff. 8-16-19.)
	503	+	6 Section 99. Effective date. This Act takes effect January
	504	+	7 1, 2024.
	505	+
	506	+
	507	+
	508	+
	509	+
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